Two years ago, Dr. Jeffrey D. Klausner started noticing a pattern among gay men seeking treatment for syphilis at his San Francisco clinic -- many of them met their sexual partners in an America Online (AOL) chat room. Eventually, Klausner, the director of STD prevention for the city's Department of Public Health, traced seven cases of syphilis in 1999 to men who met in an AOL chat room called SF M4M (San Francisco Men For Men). Since then, syphilis has spread rapidly among gay men in San Francisco, rising to 93 cases in the first nine months of this year, compared with 47 cases total last year and 29 cases in 1999.

As the disease has spread, Klausner has been trying to get the word out locally about the need for safer sex. But he hasn't been able to persuade AOL, a unit of Time Warner Inc. of New York, to post any sort of warnings or health advisories in its chat room -- or anywhere else on the service.

"All I'm asking AOL to do is an education and awareness campaign," said Klausner. AOL said it has no plans to post the warnings Klausner seeks. "We appreciate his input and we encourage him to continue bringing any concerns he has to our attention," said AOL spokesperson Andrew Weinstein. Instead, he said, AOL has been working for the past year to develop a series of sexual health advisories with the CDC. He wouldn't say when those notices would appear online. AOL said it had offered Klausner free access to its chat rooms so he could post health warnings himself. Klausner declined, saying he lacks the staff to continuously monitor the chat rooms and offer words of caution.

Studies show that people who use chat rooms to find sexual partners are more likely to have contracted STDs, according to Tom Coates, director of the AIDS Research Institute at the University of California at San Francisco. One reason is the culture of the chat rooms. "One of the norms that has developed has been a norm of unsafe [sexual] activity," said Coates. "Anything we can do to bring that norm around is helpful."

This article was provided by CDC National Prevention Information Network. It is a part of the publication CDC HIV/Hepatitis/STD/TB Prevention News Update.
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